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. 2022 Jun;27(24):2200455.
doi: 10.2807/1560-7917.ES.2022.27.24.2200455.

Extensively drug-resistant (XDR) Neisseria gonorrhoeae causing possible gonorrhoea treatment failure with ceftriaxone plus azithromycin in Austria, April 2022

Sonja Pleininger  1 , Alexander Indra  1 , Daniel Golparian  2 , Florian Heger  1 , Stefanie Schindler  1 , Susanne Jacobsson  2 , Stefan Heidler  3 , Magnus Unemo  2   4
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Extensively drug-resistant (XDR) Neisseria gonorrhoeae causing possible gonorrhoea treatment failure with ceftriaxone plus azithromycin in Austria, April 2022

Sonja Pleininger et al. Euro Surveill. 2022 Jun.

Abstract

We describe a gonorrhoea case with ceftriaxone plus high-level azithromycin resistance. In April 2022, an Austrian heterosexual male was diagnosed with gonorrhoea after sexual intercourse with a female sex worker in Cambodia. Recommended treatment with ceftriaxone (1 g) plus azithromycin (1.5 g) possibly failed. Worryingly, this is the second strain in an Asian Neisseria gonorrhoeae genomic sublineage including high-level azithromycin-resistant strains that developed ceftriaxone resistance by acquisition of mosaic penA-60.001. Enhanced resistance surveillance and actions are imperative to prevent spread.

Keywords: Neisseria gonorrhoeae; XDR; ceftriaxone resistance; extensively drug-resistant; high-level azithromycin resistance.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure
Figure
Phylogeny of the most closely related Neisseria gonorrhoeae genome sequences from a recent study [12], Asia, 2011–2018 to the extensively drug-resistant N. gonorrhoeae strain (AT159) causing a possible gonorrhoea treatment failure, Austriaa, April 2022 (n = 71 genome sequences)
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